“The Mediterranean diet extends lifespan”

## The Evidence The PREDIMED trial (Estruch et al., originally *NEJM* 2013, corrected 2018) randomised 7,447 high-cardiovascular-risk adults to Mediterranean diet plus EVOO, Mediterranean diet plus nuts, or control diet. The Med diet groups had ~30% lower rates of major cardiovascular events. A 2020 meta-analysis in *BMJ* (Dominguez et al.) pooling 12 cohort studies found Mediterranean diet adherence associated with significantly lower all-cause mortality (relative risk 0.80 for highest vs lowest adherence), cardiovascular mortality, and cancer incidence. ## Why It Works The Mediterranean diet is anti-inflammatory: high in polyphenols (EVOO, vegetables, legumes), omega-3 fatty acids (fish, nuts), and fibre; low in ultra-processed foods and red meat. These components collectively reduce CRP, improve lipid profiles, reduce oxidative stress, and support a diverse gut microbiome. ## What It Is (and Isn't) The evidence-based Mediterranean diet is characterised by: daily vegetables, legumes, olive oil, nuts, and fruits; weekly fish; moderate dairy; minimal red meat and processed food. It is not pizza and pasta.